The Diabetes Reversal Flywheel

Low Carb Diets Work, But Not the 1st Choice

It makes sense to reduce carbs, i.e., glucose, to reverse Diabetes, as high glucose levels lead to high insulin, which then stores the excess glucose as energy (glycogen & fat) in the liver, pancreas, muscles, and adipose (fat) cells.

But where is the biggest bottleneck in Diabetes?

The Biggest Constraint in Diabetes

Let's say that the rain (like refined sugars) is the cause of an accident on the highway. That accident initiates an initial block to traffic flow (stored fat in the liver), and the continued rain leads to more crashes, resulting in even more blocks.

The rain continues, but the many accidents have now blocked the highway to a standstill.

Which is the big bottleneck? The rain or the accidents?

When Diabetes is longstanding, there is multi-organ dysfunction in the liver, pancreas, muscles, and the endothelial cells of the blood vessels in the heart, brain, and legs.

Removing the blockages, ie, the accidents, will allow traffic to flow despite the continued rain. 

In the case of Diabetes, we want to first focus on removing the big bottlenecks of fat in the liver, pancreas, muscles and adipose tissue, as well as the potential plaques in the blood vessels (as this can result in life-threatening heart attacks or strokes).

Make sense?

Rapid Reversal of Diabetes

That's why Fred had such a profound effect when we focused on removing the visceral fat in the arteries and the organs. In just 2 weeks, his high blood pressure normalized without need for his two bp meds, his fasting glucose was under 6 mM (108 mg/dL) and insulin sensitivity was great at 16. His LDL cholesterol decreased from 107 mg/dL (2.83 mM) to a remarkably low level of just 34 mg/dL (0.88 mM), which is lower than his HDL at 38. He is now in plaque and fat removal mode. With exercise, he can further lower his LDL while increasing his HDL and rapidly reverse plaque.

Keeping Health vs Reversing Disease

When you are healthy, it is like being wealthy. The first rule, then, is to retain health and retain wealth. You don't have to do anything drastic when you are healthy or wealthy. Maintain a low-risk, low-reward lifestyle.

However, when disease develops, you need to seriously consider changing your lifestyle habits and consult a doctor about medicines or surgery when indicated. Now, the risks are higher, so you must reduce them significantly and seek higher rewards. Regaining lost wealth is far more challenging than maintaining it. This is a key rule for Warren Buffet: Rule #1. Don't lose money (wealth/health). Rule #2. Don't forget Rule #1. Simple right?

Does diet matter when you are healthy? 

As long as the foods are natural and whole, cultures with low disease prevalence have shown that macronutrients don't seem to matter much, whether high or low in carbs, fats, or protein.

But when disease comes, it's cause and effect. The effect is disease. What is the cause? You need to stop what is causing your disease and then allow your body to heal itself. Sometimes you need medicines to help when the disease is more advanced. 

I considered a stent, statins and baby aspirin as my coronary artery was blocked 77%. My CT heart flow showed that despite that high degree of blockage, I have a remarkably effective blood flow of 75% and my HIIT exercises must have enabled my blocked arteries to dilate enough as well as form collateral vessels (natural bypasses). I believe that I can reduce this blockage by 50% and possibly even eliminate it completely. We shall see, and by the grace of God, what happens over the next 2-3 years. And my LDL cholesterol reduced by 50% in 5 weeks and by 64% in 3 months, so there was no need for a statin. Additionally, my plaques were all stable (not low-attenuated on CT), and therefore, there was no need for a baby aspirin.

Throughout history, many cultures thrived on high-carb, fruit-rich diets without Diabetes:

Okinawans (Japan): 70% calories from sweet potatoes, fruits, vegetables → slim, long-lived, no diabetes until Western food arrived. Long life and healthspan of 85 years and most centenarians (100 year olds)

Kitavans (Papua New Guinea): diet of starchy tubers, fruits (bananas, papaya, mango), coconuts → no obesity, Diabetes, or heart disease.

Tarahumara (Mexico): corn, beans, squash, fruits → virtually no diabetes until refined foods arrived.

Hadza (Tanzania): half their calories in the rainy season from fruit & honey → still no diabetes thanks to fiber, activity, and absence of processed oils.

Traditional Pacific Islanders: breadfruit, papaya, banana, yam → no diabetes before sugar/flour/oils were introduced.

Once processed foods entered these cultures, they began to develop the diseases prevalent today. Carbs are not the true villain. It's the types of carbs (refined), fats (heated, processed, with a high omega-6 ratio) that lead to metabolic dysfunction. Whole-food carbs (fruit, beans, grains, roots) are healthy.

Reversal Flywheel

Fasting: Empties overflowing fat stores in the liver and visceral fat, providing 'clean energy' for healthy cells, and induces autophagy (the process of cleaning up cancerous and diseased cells) to recycle and eliminate metabolic waste throughout the body. The low-fat, low-calorie diet accelerates this liver fat reversal.

Healing Foods: Targeted foods that both clean up metabolic overload (LDL, glucose, fatty acids) as well as heal damaged cells, organs, systems, and restore proper hormonal balance. These healing foods replace the damaging foods you once ate, and the reversal becomes remarkable.

Exercise: Helps clear glucose into muscles and empty stored fat, allowing the body to work and run more efficiently.  This allows insulin to do its job when it needs to and return to its resting state most of the time, rather than working all the time without effect (insulin resistance leading to higher glucose and insulin levels all the time = diabetes). More vigorous exercise utilizes glucose more quickly, thereby reducing insulin requirements. This is a key for post-meal exercises.

3 Month Goal: Reverse Diabetes Completely

I believe the metabolic dysfunction that leads to Diabetes can be reversed in as little as a week, but the method to do so is very hard, as it means not eating for a week to unlock and reset your body's metabolism. If you are on drugs, there are dangers of hypoglycemia and too much fat and toxins released from the stored fat into the blood all of a sudden, which can have potential issues.

In a study of end-stage diabetics who needed amputations, a 7-day supervised water fast saved them from amputations ~half the time—quite drastic measures for a drastic consequence of Diabetes.

Another study showed that in just 2 to 7 days, liver fat can decrease by 34%, restore hepatic insulin sensitivity, and reduce fasting insulin levels by 40-60%, resulting in normal liver fat by ~8 weeks. These people were on a low-calorie, low-carb diet. (Kirk et al., Gastroenterology 2009; Taylor 2013, 2019 - "Newcastle Counterpoint program"; Luukkonen et al., PNAS 2020).

For Fred, I proposed a Reversal Protocol that I felt was 'doable'. Before he started, he said he didn't have the willpower or motivation to change anything at all. But when I sat down with him for an hour to explain what we were going to do and why it would work, he decided to try his best for three months and see. As you saw in my last newsletter, he has had remarkable results in just two weeks. 

I know this will work for the majority of people because the principles follow the metabolic principles of the body. To date, you've been putting too much of the wrong type of gas (ie: wrong types of foods) into an already full, overflowing gas tank. The excess gas is leaking out and overflowing in your blood and organs. 

Core Goals:

• Reverse insulin resistance at its root by sequentially depleting fat in those organs and restoring metabolic flexibility.

• First, the liver (1st week) - decrease fasting glucose, insulin, liver enzymes.

• Then pancreas (1st month) - decrease post-meal glucose

• Then muscle (2nd month) - increase insulin sensitivity (HOMA-IR < 1.5)

Core Goal in 1 week:

Rapidly empty liver fat stores and restore liver insulin sensitivity, so that the liver stops over-producing glucose, allowing fasting glucose and fasting insulin to normalize. Need to monitor glucose and medications if hypoglycemia.

Expected 1 week outcomes:

• Liver fat: ↓ 25-35%

• Fasting glucose: ↓ 15-30 mg/dL (1-2 mM)

• Fasting insulin: ↓ 40-50%

• Triglycerides: ↓ 10-20%

• ALT/AST (liver enzymes): 10-30%

• Weight: ↓ 2-3 kg (mostly glycogen, water and some fat)

Month 1 Goals:

• ↓ 10-20 pounds

• Fasting glucose < 6.5 mM; Post meal < 11 mM

• HbA1c ↓ 0.5-1%+

• LDL ↓ 30%+

• TG ↓ 30%+

• Meds reduced (Fred had to discontinue 4 of 6 medications due to too low blood pressure)

  • Reduce Metformin to once per day if fasting glucose < 100 mg/dL. Discontinue if fasting glucose 80-95 mg/dl.

2 week results for Fred:

• ↓ 11 pound

• Fasting glucose < 6.0mM; Post meal < 11 mM

• Fasting insulin 7 microIU/ml (great)

• Insulin resistance score 16 (<33 is insulin sensitive)

• LDL ↓ 107 mg/dL to 34 mg/dL. (decreased 68% in 2 weeks) Wow!!!

• 4 of 6 meds discontinued (due to too low blood pressure)

• Plan to remain on rosuvastatin (may reduce dosage) for cholesterol to keep LDL low for plaque reversal as found visible plaque on carotid artery ultrasound

• Plan to remain on metformin for 3 mo until HbA1c is normal (~3 months)

Month 2 Goals:

• ↓ 15-25 pounds

• Fasting glucose < 6 mM; Post meal < 10 mM

• HbA1c ↓ 1.5%+

• LDL ↓ 40%+

• TG ↓ 40%+

Month 3 Goals:

• ↓ 20-30 pounds+

• HbA1c ↓ 2-3% (remission range)

• Fasting glucose < 6 mM; Post meal < 9 mM

• LDL ↓ 50%+

• TG ↓ 50%+

• HDL ↑ 10%+

• Stop metformin end of month

Reflection

I just love this poem so much that I shall imprint it into my heart. My heart aches at all the disease in me and in people around me. Heal our bodies, our minds and our spirits, O Lord.

Ease the Heartache of Loved Ones

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Read on for a life-changing question (only one-minute more). It helped me in my life and I hope it helps you in yours.